I'd suggest you talk around the subject first. See what your
dad wants. Tell him you're interested in family information you
might find thru DNA research. You could say, "Some of this could be
uncomfortable or unsettling," and add an open ended question
like, "Is that something you'd be interested in?" or "If I find
anything like that, would you want to know?" and just wait.
Probably a moot point after all this time, but.... One of my professors in med school told the story of a deathly ill young man who had been admitted to the hospital. He knew he was really sick. A CBC (blood count/analysis) told the diagnosis within hours--acute myelogenous leukemia, back in the day when there was no good treatment, and ~100% death rate within weeks.
When the prof walked in the room, the man shouted, "Don't tell me I have leukemia!!" --Showing of course that he knew, but didn't want to be hit with the word and the terrible associations. Sometimes people know, but they don't want to be confronted with knowing.
From experience giving bad/difficult/uncomfortable news, I'd suggest you talk around the subject first. See what your dad wants.
Tell him you've done (or planning to do?) DNA testing and you're curious to find out about relatives, and mention that people have discovered relatives they didn't know about, children out of wedlock or switched at birth, secret marriages, and all sorts of unexpected family history.
Then you could say, "Some of this could be uncomfortable or unsettling," and add an open ended question like, "Is that something you'd be interested in?" or "If I find anything like that, would you want to know?" and just wait.
?Tell us how this works out?
5 Ways to Deliver Bad News With a Minimum of Pain
New research reveals why it's so hard, and a path to making it easier.
That most people have difficulty communicating bad news is reflected
in what’s called the MUM effect (“keeping mum about undesirable
messages”). In research on the MUM effect, Hope College’s Jason Dibble
and colleagues (2015) define bad news as "a message communicating
information that is previously unknown to the receiver, is anticipated
to be personally relevant to the receiver, and is perceived by the
delivery agent to be negatively valenced by the receiver”
From these studies, it seems that there is no one best way to convey
bad news, but these 5 principles should provide some guidance:
1 Tell at least part of the truth if you think the person needs to hear
it. Whether it’s a bad health prognosis or the need to let an employee
you’re firing know how to avoid repeating the trouble in the future,
there are situations when you can provide help to the person receiving
the negative message.
2 Sugarcoat it if you think the person can’t
handle it. (“It’s me not you.”) It may take you a while to frame the
right way to create a positive spin, but it will be worth the
investment, particularly if the individual seems vulnerable or
3 Follow the principles of politeness theory. It’s important
for you to help the recipient save face when the bad news involves a
potential threat to their self-esteem. You may have to develop a cover
story in order to preserve the person’s reputation to the outside
world, even if you and the other person know the actual reasons behind
4 Take your time to prepare your message. There is more
effortful cognitive processing involved in presenting people with bad
news. Make sure you consider carefully the meaning and possible
interpretations of your words. Once certain words are said they’re
impossible to take back, so don’t rush into an explanation just for
the sake of getting it over with.
5 Rely on others to help you.
Without blaming others or delegating the dirty work, keep in mind the
Igier study’s findings and consider bringing relevant other players
into the picture. It may be the other members of a work team, an
individual’s family, or even someone impartial to provide moral
support to both you and the recipient.
The good thing about PT is how it presents research info in an informal, conversational style.
And now a little drink from the fire hose....
Medical training for communication of bad news: A literature review ...
guidelines divide the interaction basically into three steps:
Preparation for communication of the news, establishing personal
contact, and the degree of knowledge of the patients regarding the
diagnosis and extent of the information they want to receive
information itself, with appropriate language and rhythm, and
empathic response to the reaction of the patient. Besides guiding the
verbal content that should be expressed, the guidelines take into
account the nonverbal impact of the quality of communication.
SPIKES: A Framework for Prognostic Discussions
The SPIKES protocol
provides an organized framework for prognostic conversations, and
indeed for many other examples of “bad news” conversations. In
addition, in 2007 the Journal of the Australian Medical Association
published the Clinical Practice Guidelines for Communicating Prognosis
and End‐of‐life Issues with Adults in the Advanced Stages of
Life‐Limiting Illness and Their Caregivers, which has expanded
communication guidelines similar to those proposed in SPIKES, but also
includes recommendations for addressing the issue of hope.
Recommendations for prognostic disclosure, based on studies of patient
preferences, guidelines, and expert opinion are described below,
following the SPIKES format.
Table 4. SPIKES: Six‐Step Protocol for Breaking Bad News
S: Setting Prepare yourself emotionally for the
anticipated conversation. Obtain all relevant laboratory, pathology,
and radiologic data, and speak with collaborating providers. Formulate
your prognostic estimate. Include pertinent persons such as the
healthcare proxy and family or friends; also consider inviting
collaborating providers. Prepare the physical environment. (Are there
enough chairs, and are tissues available?) Limit interruptions.
Perception Find out what the patient understands about his or her
disease and situation.
''What is your understanding of your health situation?''
the current state of your cancer?''
the reason we ordered the recent PET/CT?''
your progress during this hospitalization?''
your biggest concern at the moment?''
I: Invitation/Information Ask the patient what kind of information they
would like to receive. “Are you the type of person who likes to know
details or numbers, or do you prefer more general information?” “How
much would you like to know?”
K: Knowledge Provide information in
clear, nonmedical language targeted to the patient's educational level
and information preferences. Acknowledge limitations of prognostic
estimates. ''Every person is different. I can only tell you
what usually happens to patients in your situation, not exactly what
will happen to you.'' Check for patient understanding.
E: Emotion/Empathy Acknowledge patient emotions. Use NURSE acronym to
remember ways to respond to emotion.
S: Summarize/Strategize Summarize and check for patient understanding.
Assess patient goals. Avoid abandonment by establishing a follow‐up
plan for patients and caregivers that ensures regular contact.
Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses
Preferences of cancer patients regarding communication of bad news: a systematic literature review.